Putterman A M, Karesh J W
Department of Ophthalmology, University of Illinois Eye and Ear Infirmary, Chicago.
Ophthalmic Surg. 1988 Mar;19(3):193-201.
We describe the successful and stable reconstruction of 47 severely contracted sockets over a 10-year period. The surgical technique employed in all these cases used a large custom-designed, C-shaped conformer wrapped with a full-thickness oral mucous membrane graft. After all cicatricial tissue within the socket was excised, the wrapped conformer was sutured at its midperiphery to the inferior and superior orbital rims. In contrast to other procedures using flatter conformers, which direct their force in a vertical dimension, this uniquely designed conformer directs its force both vertically and deeply posteriorly within the socket. A somewhat modified but similar conformer also can be used for sockets compromised by total symblepharon formation. Excluding six patients with inadequate follow-up, we were able to successfully reform spacious and stable fornices in 40 of 41 severely contracted sockets. The average postoperative follow-up after reconstruction in these cases was 23.9 months. This technique represents an effective approach to successfully reconstruct and maintain stable ocular cul-de-sacs in cases of severe socket contracture or total symblepharon formation.
我们描述了在10年期间对47个严重挛缩眼窝进行的成功且稳定的重建。所有这些病例所采用的手术技术是使用一个大型定制的C形贴合器，并包裹全层口腔黏膜移植物。在切除眼窝内所有瘢痕组织后，将包裹好的贴合器在其外周中部缝合至眶下缘和眶上缘。与其他使用较扁平贴合器的手术不同，后者在垂直方向施加力量，而这种独特设计的贴合器在眼窝内既在垂直方向又在向后深处施加力量。一种经过某种程度改良但类似的贴合器也可用于因完全睑球粘连形成而受损的眼窝。排除6例随访不充分的患者，我们在41个严重挛缩眼窝中的40个成功重建了宽敞且稳定的穹窿。这些病例重建后的平均术后随访时间为23.9个月。该技术是一种在严重眼窝挛缩或完全睑球粘连形成的情况下成功重建并维持稳定眼窝的有效方法。
